Professor Simone Di Giovanni, Imperial College London

Regeneration and recovery following spinal cord injury

Professor Simone Di Giovanni was awarded a Brain Research UK project grant in September 2018 for research that sets out to understand the complex mechanisms underlying regeneration of nerve fibres.

Building on an existing body of research from two world-leading labs, this study will test different combinations of rehabilitation and treatment in rodents following spinal cord injury, assessing regeneration and recovery, and analysing genetic changes in the regenerating neurons.

Following rigorous assessment as part of our competitive project grant round, this project was selected for funding because the members of our Scientific Advisory Panel felt that it would make an important contribution to knowledge in an important area, with high unmet need. The panel agreed that the project would give important insight to the process of axon plasticity and regeneration, and had every confidence in the team's ability to deliver against the ambitious objectives.

About spinal cord injury

It is estimated that there are around 40,000 people living with a spinal cord injury in the UK, with around 1,000 new injuries occurring each year.

Damage to the spinal cord is irreparable. Severe spinal cord injury leads to serious, permanent impairment. Depending on the site of the injury, it may affect not only movement and sensation, but potentially also bowel and bladder function, breathing, heart rate and blood pressure. Current rehabilitation has some benefit after moderate spinal cord injury, but fails to improve recovery after more severe injuries.  

In contrast to the irreparable nature of damage to the spinal cord (which, together with the brain, forms the central nervous system, CNS), nerves in the peripheral nervous system do have the capacity to grow back.  

The peripheral nervous system is the network of nerves that links the CNS to the rest of the body. People with nerve damage in their peripheral nervous system can recover some lost function; about 30 per cent of the nerves grow back and there is often recovery of movement and function.

A key aim is to understand why nerve fibres (axons) in the peripheral nervous system regenerate when those in the CNS do not.

Read more: Brain and spinal cord injury 

Understanding regeneration and recovery

Prof Di Giovanni’s work is focused on understanding the mechanisms underlying axonal regeneration, and how these mechanisms can be exploited in the context of the spinal cord.

In this project, he is continuing a collaboration with Professor Gregoire Courtine at the Swiss Federal Institute of Technology, a world-leader in neurorehabilitation.

The team will first use electrical stimulation in combination with rehabilitation in rodents with spinal cord injury.

They will then use these techniques in combination with a drug that has been previously shown to promote axonal regeneration.

Functional recovery and axonal regeneration will be assessed at both stages, and the team will also analyse changes in gene expression in the relevant neurons. This will give a better understanding of the molecular events underpinning recovery and regeneration and will inform the design of new therapies.

“Both Giovanni and Courtine are at the forefront of the field of molecular mechanisms of axonal regeneration and mechanistic approaches to rehabilitation of the nervous system, respectively. This collaboration is really exciting, given the outstanding experience and productivity of the investigators.” External reviewer.   

Impact

There is currently no treatment that can repair a spinal cord injury. Those affected live in hope of a breakthrough that may help them regain lost function.

This exciting project builds on an existing collaboration between two world-leading teams who will apply their combined expertise and skills to advance our understanding of the mechanisms involved in nerve regeneration. This will underpin efforts to develop interventions that can promote repair of the spinal cord and enable people with spinal cord injuries to recover function.

This is an exciting and innovative project that is sure to generate findings highly relevant to spinal cord repair in humans.” External reviewer.

Related research projects

Acquired brain and spinal cord injury is one of our current priority research themes. Our aim is to fund research to advance understanding of how to promote repair of the brain and spinal cord following injury.

In addition to Prof Di Giovanni’s project, we are funding the following projects under this theme: